Provider Demographics
NPI:1144706672
Name:WILKINSON, ANNA MARIE (STNA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5944 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3649
Mailing Address - Country:US
Mailing Address - Phone:419-261-0332
Mailing Address - Fax:
Practice Address - Street 1:5944 WAKEFIELD DR
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3649
Practice Address - Country:US
Practice Address - Phone:419-261-0332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401564530813376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide